UNDERSTANDING

PROSTATE CHANGES

A HE ALTH GUIDE FOR MEN

PATIENT U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

&family
EDUCATION
National Institutes of Health
National Cancer Institute
Table of Contents
Introduction to the Prostate .................................................1
What is the prostate? ................................................................2
How does the prostate change as you get older? .....................3
What prostate changes should you be aware of?.....................4
What are common tests for prostate changes? ........................4

Prostate Changes That Are Not Cancer .................................5

What is prostatitis and how is it treated? ................................5
What is enlarged prostate or BPH? ...........................................9
How can BPH be treated?........................................................11

Prostate Cancer ....................................................................17

Things to know .......................................................................17
Symptoms................................................................................19
Risk factors ..............................................................................19
Can prostate cancer be prevented?.........................................20

Talking to Your Doctor.........................................................22

Types of Tests .......................................................................23

Health history and current symptoms ...................................23
Digital rectal exam (DRE)........................................................23
Prostate-specific antigen test (PSA test) ..................................24
What do PSA results mean? ....................................................25
Prostate biopsy ........................................................................25
Deciding about repeat biopsy .................................................26
If a biopsy is positive ..............................................................26

For More Information ..........................................................29

Words to Know ....................................................................31

 1

Introduction to the Prostate

You may be reading this booklet because you are having prostate
problems. The booklet can help answer your questions about
prostate changes that happen with age, such as:

What are common prostate changes?

How are these changes treated?

What do I need to know about testing for prostate

changes, including cancer?

This booklet can give you basic information about common

prostate changes. If you are making decisions about prostate
cancer treatment, there are other resources available. See the For
More Information section on page 29.

Important words are in bold, and their meanings

are listed in the Words to Know section on page 31.
2 3

What is the prostate? How does the prostate change as you get older?
The prostate is a small gland in men. It is part of the male The prostate gland surrounds the tube (urethra) that passes urine.
reproductive system. This can be a source of problems as a man ages because:

The prostate is about The prostate tends to grow bigger with age and may
the size and shape of squeeze the urethra (see drawing on page 10) or
a walnut. It sits low A tumor can make the prostate bigger
in the pelvis, below
the bladder and These changes, or an infection, can cause problems passing urine.
just in front of the Sometimes men in their 30s and 40s may begin to have these
rectum. The urinary symptoms and need medical attention. For others,
prostate helps make symptoms arent noticed until much later in life. Be sure to tell
semen, the milky your doctor if you have any urinary symptoms.
fluid that carries
sperm from the
testicles through
the penis when a Tell your doctor if you:
man ejaculates.

The prostate surrounds part of the urethra, a tube that carries Are passing urine more during the day
urine out of the bladder and through the penis.
Have an urgent need to pass urine

Have less urine flow

Feel burning when you pass urine

Need to get up many times during the night to

pass urine
4 5

What prostate changes should you be aware of?
Growing older raises your risk of prostate problems. The three
most common prostate problems are:
Infection (prostatitis)
Enlarged prostate (BPH, or benign prostatic
hyperplasia)
Prostate cancer
Prostate Changes That Are Not Cancer
What is prostatitis and how is it treated?
Prostatitis (pronounced "PRAH-stuh-TYE-tis") is an inflammation or
infection of the prostate gland. It affects at least half of all men at
some time in their lives. Having this condition does not increase
your risk of any other prostate disease.

One change does not lead to another. For example, having

prostatitis or an enlarged prostate does not raise your chance of
prostate cancer. It is also possible for you to have more than one Prostatitis Symptoms
condition at the same time.
Trouble passing urine or pain when passing urine
Most men have prostate changes that are not A burning or stinging feeling when passing urine
cancer.
Strong, frequent urge to pass urine, even when there
is only a small amount of urine
Chills and high fever
What are common tests for prostate changes?
Low back pain or body aches
Abnormal findings from any of these tests can help diagnose a
problem and suggest the next steps to take: Pain low in the belly, groin, or behind the scrotum
Rectal pressure or pain
DRE (digital rectal exam)a test to feel the prostate
Urethral discharge with bowel movements
PSA (prostate-specific antigen) testa blood test
Genital and rectal throbbing
Biopsya test to check for cancer
Sexual problems and loss of sex drive
See the Types of Tests section on page 23. Blocked urine
Painful ejaculation (sexual climax)
6 7

Prostatitis is not contagious. It is not spread through sexual
contact. Your partner cannot catch this infection from you.
Several tests, such as DRE and a urine test, can be done to see if
you have prostatitis. Getting the right diagnosis of your exact type
of prostatitis is the key to getting the best treatment. Even if you
have no symptoms, you should follow your doctors suggestion to
complete treatment.
There are four types of prostatitis:
This type of treatment clears up about 60 percent of
cases. Long-term, low-dose antibiotics may help
relieve symptoms in cases that wont clear up.
Chronic prostatitis or chronic pelvic pain
syndrome
This disorder is the most common but least understood form of
the disease. Found in men of any age from late teens to elderly, its
symptoms go away and then return without warning. There can
be pain or discomfort in the groin or bladder area.

Acute bacterial prostatitis Treatment: There are several different treatments for this
problem, based on your symptoms. These include
This infection comes on suddenly (acute) and is caused by
antibiotics and other medicines, such as alpha-
bacteria. Symptoms include severe chills and fever. There is often
blockers. Alpha-blockers relax muscle tissue in the
blood in the urine. You must go to the doctors office or
prostate to make passing urine easier.
emergency room for treatment. Its the least common of the four
types, yet its the easiest to diagnose and treat.
Asymptomatic inflammatory prostatitis
Treatment: Most cases can be cured with a high dose of
You usually dont have symptoms with this condition. It is often
antibiotics, taken for 7 to 14 days, and then lower
found when your doctor is looking for other conditions like
doses for several weeks. You may also need drugs to
infertility or prostate cancer. If you have this problem, often
help with pain or discomfort.
your PSA test (see page 24) will show a higher number than
normal. It does not necessarily mean that you have cancer.
Chronic bacterial prostatitis
Treatment: Men with this condition are usually given antibiotics
Also caused by bacteria, this condition doesnt come on suddenly,
for 4 to 6 weeks, and then have another PSA test.
but it can be bothersome. The only symptom you may have is
bladder infections that keep coming back. The cause may be a
defect in the prostate that lets bacteria collect in the urinary tract.

Treatment: Antibiotic treatment over a longer period of time is

best for this type. Treatment lasts from 4 to 12 weeks.
 9

What is enlarged prostate or BPH?

BPH stands for benign prostatic hyperplasia (pronounced "be-NINE
prah-STAT-ik HY-per-PLAY-zha").

Benign means "not cancer," and hyperplasia means too much

growth. The result is that the prostate becomes enlarged. BPH is
not linked to cancer and does not raise your chances of getting
prostate canceryet the symptoms for BPH and prostate cancer
can be similar.

BPH Symptoms

BPH symptoms usually start after the age of 50.

They can include:
Trouble starting a urine stream or making more than a
dribble
Passing urine often, especially at night
Feeling that the bladder has not fully emptied
A strong or sudden urge to pass urine
Weak or slow urine stream
Stopping and starting again several times while passing urine

Changes happen so slowly that you dont
even realize theyre happening.
Pushing or straining to begin passing urine
At its worst, BPH can lead to:
A weak bladder
Backflow of urine causing bladder or kidney infections
Complete block in the flow of urine
Kidney failure
10
BPH affects most men as they get older. It can lead to urinary
problems like those with prostatitis. By age 60, many men have
signs of BPH. By age 70, almost all men have some prostate
enlargement.
The prostate starts out about the size of a walnut. By the time a
man is 40, it may have grown slightly larger, to the size of an
apricot. By age 60, it may be the size of a lemon.
As a normal part of aging, the prostate enlarges and can press
against the bladder and the urethra. This can slow down or block
urine flow. Some men might find it hard to start a urine stream,
even though they feel the need to go. Once the urine stream has
started, it may be hard to stop. Other men may feel like they need
to pass urine all the time or are awakened during sleep with the
sudden need to pass urine.
Early BPH symptoms take many years to turn into bothersome
problems. These early symptoms are a cue to see your doctor.
Urine flow of normal (left) and enlarged prostate (right). In diagram on
the left, urine flows freely. On the right, urine flow is affected because of
the prostate pressing on the bladder and urethra.
11
How can BPH be treated?
About half the men with BPH eventually have symptoms that are
bothersome enough to need treatment. BPH cannot be cured, but
drugs or surgery can often relieve its symptoms. BPH symptoms
do not always grow worse.
There are three ways to manage BPH:
Watchful waiting (regular follow-up with your doctor)
Drug therapy
Surgery
Talk with your doctor about the best choice for you. Your
symptoms may change over time, so be sure to tell your doctor
about any new changes.
Watchful waiting
Men with mild symptoms of BPH who do not find them
bothersome often choose this approach.
Watchful waiting means getting annual checkups. The checkups
can include DREs and other tests (see page 23). Treatment is
started only if symptoms become too much of a problem.
If you choose to live with symptoms, these simple steps can help:
Limit drinking in the evening, especially drinks with
alcohol or caffeine.
Empty the bladder all the way when you pass urine.
Use the restroom often. Dont wait for long periods
without passing urine.

My doctor and I decide visit by visit about
how long I should stay on watchful waiting
for my BPH.
13
Some medications can make BPH symptoms worse, so talk with
your doctor or pharmacist about any medicines you are taking
such as:
Over-the-counter cold and cough medicines (especially
antihistamines)
Tranquilizers
Antidepressants
Blood pressure medicine
Drug therapy
Millions of American men with mild-to-moderate BPH symptoms
have chosen prescription drugs over surgery since the early 1990s.
There are two main types of drugs used. One type relaxes muscles
near the prostate while the other type shrinks the prostate gland.
There is evidence that shows that taking both drugs together may
work best to keep BPH symptoms from getting worse.
Alpha-blockers
These drugs help relax muscles near the prostate to relieve pressure
and let urine flow more freely, but they dont shrink the size of the
prostate. For many men, the drug can improve urine flow and
reduce symptoms within days. Possible side effects include
dizziness, headache, and fatigue.
5 alpha-reductase inhibitor
This drug, known as finasteride, shrinks the prostate. It relieves
symptoms by blocking an enzyme that acts on the male
hormone, testosterone, to boost organ growth. When the enzyme
is blocked, growth slows down. This helps shrink the prostate,
reduce blockage, and limit the need for surgery.
14 15

Taking this drug for at least 6 months to 1 year can increase urine
flow and reduce your symptoms. It seems to work best for men
with very large prostates. You must continue to take the drug to
prevent symptoms from coming back.
This drug is also used to treat baldness in men. It can cause these
side effects in a small percentage of men:
Decreased interest in sex
Trouble getting or keeping an erection
Smaller amount of semen with ejaculation
Its important to note that taking this drug can lower your PSA test
levels. There is also evidence that finasteride lowers the risk of
getting prostate cancer, but whether it lowers the risk of dying
from prostate cancer is still unclear.
BPH surgery
The number of prostate surgeries has gone down over the years.
But operations for BPH are still one of the most common surgeries
for American men. Surgery is used when symptoms are severe or
drug therapy has not worked well.
Types of surgeries include:
TURP (transurethral resection of the prostate) is the most
common surgery for BPH. It accounts for 90 percent of all
BPH surgeries. It takes about 90 minutes. The doctor passes
an instrument through the urethra and trims away extra
prostate tissue. A spinal block is used to numb the area.
Tissue is sent to the laboratory to check for prostate cancer.
TURP generally avoids the two main dangers linked to other
prostate surgeries:

Incontinence (not being able to hold in urine)

Impotence (not being able to have an erection)

BPH Medications
The recovery period for TURP is much shorter as well.
Category Activity Generic Name Brand Name TUIP (transurethral incision of the prostate) is similar to
TURP. It is used on slightly enlarged prostate glands. The
Alpha-blockers Relax muscles doxazosin Cardura
surgeon places one or two small cuts in the prostate. This
near prostate
tamsulosin Flomax relieves pressure without trimming away tissue. It has a low
terazosin Hytrin risk of side effects. Like TURP, this treatment helps with urine
flow by widening the urethra.
prazosin Minipres
TUNA (transurethral needle ablation) burns away excess
5 alpha- Slows prostate finasteride Proscar or prostate tissue using radio waves. It helps with urine flow,
reductase growth, shrinks Propecia relieves symptoms, and may have fewer side effects than TURP.
inhibitor prostate
Most men need a catheter to drain urine for a period of time
after the procedure.
16
TUMT (transurethral microwave thermotherapy) uses
microwaves sent through a catheter to destroy excess prostate
tissue. This can be an option for men who should not have
major surgery because they have other medical problems.
TUVP (transurethral electroevaporation of the prostate)
uses electrical current to vaporize prostate tissue.
Open prostatectomy means the surgeon removes the prostate
through a cut in the lower abdomen. This is done only in very
rare cases when obstruction is severe, the prostate is very large,
or other procedures cant be done. General or spinal
anesthesia is used and a catheter remains for 3 to 7 days after
the surgery. This surgery carries a higher risk of complications
than medical treatment. Tissue is sent to the laboratory to
check for prostate cancer.
Be sure to discuss options with your doctor and ask about the
potential short- and long-term benefits and risks with each
procedure. A list of questions to ask is on page 28.
17
Prostate Cancer
Things to know
Prostate cancer means that cancer cells form in the tissues of the
prostate. It is the most common cancer in American men after
skin cancer.
Prostate cancer tends to grow slowly compared with most other
cancers. Cell changes may begin 10, 20, or 30 years before a
tumor gets big enough to cause symptoms. Eventually, cancer
cells may spread (metastasize) throughout the body. By the time
symptoms appear, the cancer may be more advanced.
By age 50, very few men have symptoms of prostate cancer, yet
some precancerous or cancerous cells are present. More than
half of all American men have some cancer in their prostate glands
by the age of 80.
Most of these cancers never pose a problem. They either give no
signs or symptoms or never become a serious threat to health.
A much smaller percentage of men are actually treated for prostate
cancer. Most men with prostate cancer do not die from this disease.
About 16 percent of American men are diagnosed with
prostate cancer at some point in their lives.
Eight percent have serious symptoms.
Three percent die of the disease.

When I first learned I might have a prostate
problem, I was afraid it was cancer.
19
Symptoms
Prostate cancer can sit quietly for years. That means most men
with the disease have no obvious symptoms. When symptoms
finally appear, they may be a lot like the symptoms of BPH.
Prostate Cancer Symptoms
Trouble passing urine
Frequent urge to pass urine, especially at night
Weak or interrupted urine stream
Pain or burning when passing urine
Blood in the urine or semen
Painful ejaculation
Nagging pain in the back, hips, or pelvis
Prostate cancer can spread to the lymph nodes of the pelvis.
Or it may spread throughout the body. It tends to spread to the
bones. So bone pain, especially in the back, can be another
symptom.
Risk factors
There are some risk factors linked to prostate cancer. A risk factor
is something that can raise your chances of having a problem or
disease. Having one or more risk factors doesnt mean that you
will get prostate cancer. It just means that your risk of disease is
greater.
Age. Being 50 or older increases risk of prostate cancer.
Race. African-American men are at highest risk of prostate
cancerit tends to start at younger ages and grows faster than
20
in men of other races. After African-American men, it is most
common among white men, followed by Hispanic and Native
American men. Asian-American men have the lowest rates of
prostate cancer. Aside from race, all men can have other
prostate cancer risk factors (aging, family history, and diet).
See the For More Information section to request the booklet
about African-American men and prostate cancer screening.
Family history. Prostate cancer risk is 2 to 3 times higher for
men whose fathers or brothers have had the disease. For
example, risk is about 10 times higher for a man who has 3
immediate family members with prostate cancer. The younger
a man is when he has prostate cancer, the greater the risk for
his male family members. Prostate cancer risk also appears to
be slightly higher for men whose mothers or sisters have had
breast cancer.
Diet. The risk of prostate cancer seems to be higher for men
eating high-fat diets with few fruits and vegetables.
Can prostate cancer be prevented?
National research studies are looking at how prostate cancer can be
prevented. There is some proof that the drug finasteride lowers
your risk of getting prostate cancer, but whether it decreases the
risk of dying of prostate cancer is still unclear.
To find out more, see the For More Information section on page 29.
21
Prostate Cancer Screening
Screening means testing for cancer before you have any
symptoms. A screening test can often help find cancer at an
early stage. When found early, cancer is less likely to have
spread and may be easier to treat. By the time symptoms
appear, the cancer may have started to spread. Remember,
even if your doctor suggests prostate cancer screening, this
doesnt necessarily mean that you have cancer.
Screening tests are most useful when they have been proven to
find cancer early and lower a persons chance of dying from
cancer. For prostate cancer, doctors dont yet know these
answers and more research is being done.
Large research studies, with thousands of men, are going on
now to study prostate cancer screening. The National
Cancer Institute is studying the combination of PSA testing
and DRE as a way to get more accurate results.
Some cancers never cause symptoms or become life-
threatening. If they are found by a screening test, the
cancer may then be treated. For prostate cancer in its early
stages, it isnt known whether treatment would help you live
longer than if no treatment were given when a screening
test detects prostate cancer.
Talk with your doctor about your risk of prostate
cancer and your need for screening tests.
22 23

Talking to Your Doctor Types of Tests

Different kinds of doctors and other health care professionals
manage prostate health. They can help you find the best care,
answer your questions, and address your concerns. These health
care professionals include:
Family doctors and internists
Physician assistants (PAs) and nurse practitioners (NPs)
Urologists, who are experts in diseases of the male
reproductive and urinary tract systems
These types of tests are most often used to check the prostate:
Health history and current symptoms
This first step lets your doctor hear and understand the "story" of
your prostate concerns. Youll be asked about whether you have
symptoms, how long youve had them, and how much they affect
your lifestyle. Your health history also includes any risk factors,
pain, fever, or trouble passing urine. You may be asked to give a
urine sample for testing.

Urologic oncologists, who are experts in treating cancers of the Digital rectal exam
male urinary and reproductive systems such as prostate cancer
DRE is the standard way to check the prostate. With a gloved and
Radiation oncologists, who use radiation therapy to kill cancer lubricated finger, your doctor feels the prostate from the rectum.
cells The test lasts about 1015 seconds.
Medical oncologists, who treat cancers with medications such
as hormone treatments and chemotherapy

Pathologists, who are doctors who find diseases by studying

cells and tissues under a microscope

View these professionals as your partnersexpert advisors and

helpers in your health care. Talking openly with your doctors can
help you learn more about your prostate changes and the tests to
expect.
24
This exam checks for:
The size, firmness, and texture of the prostate
Any hard areas, lumps, or growth spreading beyond the
prostate
Any pain caused by touching or pressing the prostate
The DRE allows the doctor to feel only one side of the prostate.
A PSA test is another way to help your doctor check your prostate.
PSA (Prostate-Specific Antigen) test
PSA is a protein made by normal cells and prostate cancer cells. It
is found in the blood and can be measured with a blood test. PSA
tests are often used to follow men after prostate cancer treatment.
PSA testing is still being studied to see if finding cancer early
lowers the risk of dying from prostate cancer.
PSA levels can rise if a man has prostate cancer, but a high PSA is
not proof of cancer. Other things can also make PSA levels go up.
These may give a false positive test result. These include having
BPH or prostatitis, or if the prostate gland is disturbed in any way
(riding a bicycle or motorcycle, a DRE, orgasm within the past 24
hours, and prostate biopsy or surgery can disturb the prostate).
Also, some prostate glands naturally produce more PSA than
others. PSA levels go up with age. African-American men tend to
have higher PSA levels in general than men of other races.
Researchers are trying to find more answers about:
The PSA tests ability to tell cancer from benign prostate
problems
The best thing to do if a man has a high PSA level
For now, men and their doctors use PSA readings over time as a
guide to see if more follow-up is needed.
25
What do PSA results mean?
PSA levels are measured in terms of units per volume of fluid
tested. Doctors often use a score of 4 nanograms (ng) or higher
as the trigger for further tests, such as a prostate biopsy.
Your doctor may monitor your PSA velocity, which means looking
at the rate of change in your PSA levels over time. Rapid increases
in PSA readings can suggest cancer. If you have a mildly elevated
PSA, you and your doctor may choose to check PSA levels on a
scheduled basis and watch for any change in the PSA velocity.
Prostate biopsy
If your symptoms or test results suggest cancer, your doctor will
refer you to a specialist (a urologist) for a prostate biopsy. A
biopsy is usually done in the doctors office.
For a biopsy, small tissue samples are taken directly from the
prostate. Your doctor will take samples from several areas of the
prostate gland. This can help lower the chance of missing any
areas of the gland that may have cancer cells. Like other cancers,
doctors can only diagnose prostate cancer by looking at tissue
under a microscope.
Most men who have biopsies after routine exams do not have cancer.
There is no magic PSA level below which a man can be assured of
having no risk of prostate cancer nor above which a biopsy should
automatically be performed. A man's decision to have a prostate
biopsy requires a thoughtful discussion with his physician,
considering not only the PSA level, but also his other risk factors,
his overall health status, and how he perceives the risks and
benefits of early detection.
Dr. Howard Parnes, Chief of the Prostate and Urologic Cancer Research Group,
Division of Cancer Prevention, National Cancer Institute
26

Deciding about repeat biopsy

A test that can help your doctor decide if you need a repeat biopsy
is called free PSA. This test is used for men who have higher PSA
values. The test looks at a form of PSA in the blood. Free PSA is
linked to BPH but not cancer.
Free PSA is figured as a percentage of the total PSA:

If both total PSA and free PSA are higher than normal, this
suggests BPH rather than cancer.

If regular PSA is high but free PSA is not, cancer is more

likely. More testing should be done.
Free PSA may help tell what kind of prostate problem you have. It
can be a guide for you and your doctor to choose the right
treatment. You and your doctor should talk about your personal
risk and free PSA results. Then you can decide together whether to
have follow-up biopsies and, if so, how often.

If a biopsy is positive While its important to make your own decision

A positive biopsy means prostate cancer is present. A pathologist about cancer screening, everybody should
will check your biopsy sample for cancer cells and will give a
consider getting a second opinion before
Gleason score. The Gleason score ranges from 2 to 10 and
describes how likely it is that a tumor will spread. The lower the getting something like a biopsy.
number, the less likely the tumor is aggressive and may spread.
Treatment options depend on the stage (or extent) of the cancer
(stages range from 1 to 4), Gleason score, PSA level, and your age
and general health. These items will be available from your doctor
and are listed on your pathology report.

Reaching a decision about treatment of your prostate cancer is a

complex process. Many men find it helpful to talk with their
doctors, family, friends, and other men who have faced similar
decisions. There are many organizations that can provide more
information and support to you, your partner, and family.
It is a good idea to get a copy of your pathology report
from your doctor and carry it with you as you talk with
your health care providers.
28
Checklist of Questions for Your Doctor
What type of prostate problem do I have?
Is more testing needed and what will it tell me?
If I decide on watchful waiting, what changes in my
symptoms should I look for and how often should I
be tested?
What type of treatment do you recommend for my prostate
problem?
For men like me, has this treatment worked?
How soon would I need to start treatment and how long
would it last?
Do I need medicine and how long would I need to take it
before seeing improvement in my symptoms?
What are the side effects of the medicine?
Are there other medicines that could interfere with this
medication?
If I need surgery, what are the benefits and risks?
Would I have any side effects from surgery that could affect
my quality of life?
Are these side effects temporary or permanent?
How long is recovery time after surgery?
Will I be able to fully return to normal?
How will this affect my sex life?
How often should I visit the doctor to monitor my condition?
29
For More Information
National Cancer Institute
You can find out more from these free NCI services.
Cancer Information Service (CIS)
Toll-free ................1-800-4-CANCER (1-800-422-6237)
TTY ........................1-800-332-8615
NCI Online ............www.cancer.gov
Chat Online ..........www.cancer.gov and click on Need Help?
Free booklets that are available include:
What You Need To Know About Prostate Cancer
Know Your Options: Understanding Treatment Choices for
Prostate Cancer
Other Federal Resources
Centers for Disease Control and Prevention
Toll-free ................1-888-842-6355
FAX ........................1-770-488-4760
E-mail ....................cancerinfo@cdc.gov
Online....................www.cdc.gov/cancer/prostate
Free booklets that are available include:
Prostate Cancer Screening: A Decision Guide
Prostate Cancer Screening: A Decision Guide for African Americans
30
Medicare
For more information about Medicare benefits, contact:
Toll-free ................1-800-MEDICARE (1-800-633-4227)
Online....................www.medicare.gov
National Kidney and Urologic Diseases Information
Clearinghouse
Toll-free ................1-800-891-5390
Online....................www.niddk.nih.gov
31
Words to Know
acute: Symptoms or signs that begin and get worse quickly. The
opposite of acute is chronic.
alpha-blockers: Drugs that relax muscles in the prostate. Alpha-
blockers are used to treat BPH.
alpha-reductase inhibitor (al-fuh reh-DUK-tays in-HIH-buh-tur): A drug
that shrinks the prostate gland, used to treat BPH.
antibiotic (an-tih-by-AH-tik): A drug used to treat infections caused by
bacteria and other microorganisms.
antidepressants: Drugs used to treat depression.
asymptomatic (AY-simp-tum-AT-ik): Having no signs or symptoms of
disease.
benign (beh-NINE): Not cancerous. Benign tumors do not spread to
tissues around them or to other parts of the body.
biopsy (BY-ahp-see): To remove cells or tissues from the body and
examine them under a microscope. When doctors remove only a sample
of tissue, it is called an incisional biopsy or core biopsy. When a whole
tumor or lesion is removed, it is called an excisional biopsy. When
doctors use a needle to remove a sample of tissue or fluid, it is called a
needle biopsy or fine-needle biopsy.
bladder: The organ that stores urine.
BPH: BPH stands for benign prostatic hyperplasia (be-NINE prah-STAT-ik
HY-per-PLAY-zha). BPH is when an overgrowth of prostate tissue pushes
against the urethra and the bladder, blocking the flow of urine. BPH is a
benign (not cancerous) condition. Also called benign prostatic
hypertrophy.
catheter (KATH-ih-ter): A flexible tube used to deliver fluids into or
withdraw fluids from the body.
chronic (KRAH-nik): A disease or condition that stays bad or gets worse
over a long period of time.
DRE: DRE stands for digital rectal exam. An exam where a doctor puts a
lubricated, gloved finger into the rectum to feel for abnormalities.
32
ejaculate (ee-JAK-yuh-layt): To release semen through the penis. This
happens when a man has an orgasm.
enzyme (EN-zym): A protein that speeds up chemical reactions in the
body.
erection: When the penis temporarily gets longer, thicker, and harder.
This happens because the nervous system increases the blood flow to the
veins and spongy tissues of the penis.
false positive: A test result that says a condition exists, when in fact it
does not.
finasteride: A drug used to reduce the amount of male hormone
(testosterone) produced by the body.
free PSA: Free PSA stands for prostate-specific antigen type II assay. This
is a test that reports the percentage of free PSA to total PSA in a mans
blood. PSA (prostate-specific antigen) is a chemical in all mens blood.
Free PSA is PSA that is not attached to another chemical. Free PSA is
linked to BPH, but not to cancer. So measuring free PSA helps to tell
what kind of prostate problem a man has.
genital (JEN-uh-tul): The area around male and female sex organs.
Gleason score (GLEE-sun): A system of grading prostate cancer cells
based on how they look under a microscope. Gleason scores range from 2
to 10 and indicate how likely it is that a tumor will spread. A low
Gleason score means the cancer cells are similar to normal prostate cells
and are less likely to spread; a high Gleason score means the cancer cells
are very different from normal and are more likely to spread.
hyperplasia (high-pur-PLAY-zha): An abnormal increase in the number of
cells in an organ or tissue.
infertility: The inability to produce children.
lymph (limf) node: Part of the lymphatic system. A lymph node is a
rounded mass surrounded by a sac of connecting tissue. Lymph nodes
are found along lymphatic vessels. Lymph nodes filter lymph and store
white blood cells. Also called a lymph gland.
metastasize (meh-TAS-tuh-size): To spread from one part of the body to
another. When cancer cells metastasize and form secondary tumors, the
cells in the new tumor are like those in the original (primary) tumor.
33
nanogram (NAN-uh-gram): A measure of weight. One nanogram weighs
a billion times less than one gram, and almost a trillion times less than a
pound.
pathologist (pa-THOL-o-jist): A doctor who identifies diseases by
studying cells and tissues under a microscope.
pelvis: The lower part of the belly, between the hip bones.
penis (PEE-nus): An external male reproductive organ. It contains a
tube called the urethra, which carries semen and urine to the outside
of the body.
precancerous (PRE-KAN-ser-us): Describes a condition that may (or is
likely to) become cancer. Also called premalignant.
prostate (PRAH-stayt): A gland in the male reproductive system just
below the bladder. It makes a fluid that forms part of semen. The
prostate surrounds part of the urethra, the tube that empties the bladder.
prostatitis (prah-stuh-TYE-tis): Inflammation of the prostate gland.
PSA: PSA stands for prostate-specific antigen (PRAH-stayt speh-SIH-fik
AN-tih-gin). A substance produced by the prostate that may be found in
an increased amount in the blood of men who have prostate cancer,
benign prostatic hyperplasia, or infection or inflammation of the
prostate.
PSA test: A blood test to measure PSA, a substance produced by prostate
gland cells. This level rises when there is a problem with the prostate
gland. But the PSA test cannot tell whether the problem is cancer or
another condition.
rectum: The last several inches of the large intestine, ending at the anus.
reproductive system: The reproductive system in men includes the
prostate, the testicles, and the penis.
scrotum (SKROH-tum): In men, the external sac that contains the
testicles.
semen: The fluid that is released through the penis during orgasm.
sperm: The male reproductive cell, formed in the testicle. A sperm joins
with an egg to form an embryo.
34

spinal block: A type of anesthesia that numbs the lower half of the body.
testicles (TES-tih-kuls): The two egg-shaped glands found inside the
scrotum. They produce sperm and male hormones. Also called testes.
tumor (TOO-mer): An abnormal mass of tissue that results from
excessive cell division. Tumors may be benign (not cancerous) or
malignant (cancerous). Also called neoplasm.
urethra (yoo-REE-thra): The tube through which urine leaves the body.
It empties urine from the bladder.
urinary (YOOR-in-air-ee): Having to do with urine or the organs of the
body that produce and get rid of urine.
urine (YOOR-in): Fluid containing water and waste products. Urine is
made by the kidneys, stored in the bladder, and leaves the body through
the urethra.
urologist (yoo-RAH-luh-jist): A doctor who specializes in diseases of the
urinary organs in females and the urinary and sex organs in males.
NIH Publication No. 02-5199
Printed August 2004